Lifesaving drug, no prescription needed

Wednesday

Apr 19, 2017 at 11:00 AM

Zachary Comeau Daily News Staff @zwcomeau

Although more than 800 pharmacies in the state carry overdose-reversing naloxone – including dozens in the area - a recent Boston Medical Center study suggests that pharmacies should proactively offer the medication to certain customers.

The study, which was published last month in the Journal of the American Pharmacists Association, found that patients and their families are reluctant to ask about purchasing naloxone, sometimes sold under the brand name Narcan, at pharmacies.

Additionally, pharmacists may be reluctant to bring up the subject out of fear of offending patients, the study suggests.

According to the state Department of Public Health, more than 800 pharmacies in the state have a standing order – meaning a prescription is not needed - to offer naloxone, including all CVS Pharmacy locations and most other retail pharmacy locations.

According to spokesman Erin Britt, CVS pharmacies either have naloxone in stock or it can be ordered the same day. For those without insurance, the drug would cost about $110 for brand name Narcan nasal spray, or $45 for an intramuscular dose.

The company began distributing naloxone under a standing order in April 2015, and many other retail pharmacies followed suit.

The study’s lead author, Traci Green, suggested that pharmacies could offer naloxone to everyone with a long-term opioid prescription and forming a policy to offer the drug to every patient prescribed opioids with a high-risk of addiction.

Across the state, opioid-related deaths have been skyrocketing. In 2010, there were only 532 such deaths, but that rose to an estimated 1,979 in 2016.

Most communities are also seeing an increase. In Franklin, the number of overdoses and related deaths has risen each year since 2014, when there were 39 overdoses and three deaths. Last year, there were 58 overdoses and nine deaths. There haven't been any deaths this year, but there have already been 16 overdoses in Franklin.

Amy Leone of Community Impact has been on the front lines of the epidemic in Milford, where opioid overdoses nearly doubled from 2015 to last year, from 48 to 92. Overdose deaths also nearly quadrupled in that same span, from four to 15.

So far this year, there have been 25 overdoses and two deaths, according to police.

Though many of her patients will one way or another have access to naloxone either directly or through a family member, Leone said addicts are still hesitant to go into pharmacies to get what they need, but not so much with naloxone.

Instead, a larger stigma is attached to an addict buying needles at a pharmacy, Leone said.

That is where some say naloxone should be offered, since pharmacies are a major source of syringes for many opioid addicts.

“Most of the fatal overdoses have been fentanyl-involved, and not prescribed fentanyl,” said Jared Owen, communications director for the Massachusetts Organization for Addiction Recovery. “Rather than people getting prescription opioids and overdosing on them, it’s really the people using the illicit drugs.”

Focusing on getting naloxone into the hands of people going to pharmacies for syringes could be more effective and less cost-prohibitive than providing the anti-overdose medication to prescription opioid patients who are at a lower risk of overdosing, he said.

When asked, Britt said the practice would be better suited as a public health campaign rather than a pharmacy’s policy. A DPH spokesperson could not be reached for comment on the matter. In many recovery support groups, including for addicts’ families, training in administering naloxone is provided, and the drug is often provided for free.

The DPH’s State Without Stigma campaign that sought to remove the stereotype and stigma associated with opioid abuse, Leone said, helped immensely in providing access to naloxone and other treatment.

Leone, who also runs a regional substance abuse prevention program in conjunction with the Milford Police Department, said most of her patients do have naloxone “in their homes or in their cars.”

If the addict doesn’t have it, someone in their family does, she said.

Recently, hospitals are making sure than an addict has access to the drug before they're discharged, including a prescription for it, Leone said.

"Now, we need treatment,” she said.

Information from a previous story by Wicked Local Newsbank Editor Gerry Tuoti was used in this report.

Zachary Comeau can be reached at 508-634-7556 and zcomeau@wickedlocal.com. Follow him on Twitter @ZComeau_MDN.

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